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Effects of Caffeinated and Decaffeinated Coffee on Hemodialysis-Related Headache (CoffeeHD): A Randomized Multicenter
Mabel H Aoun1, Najla Hilal2, Chadia Beaini3
1Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon; Department of Nephrology, Saint-Georges Hospital, Ajaltoun, Lebanon.
Insights
Caffeine in regular coffee did not significantly alter headache or hypotension incidence in hemodialysis patients. Headache occurred in 35% of patients, regardless of coffee type consumed during dialysis.
Area of Science:
- Nephrology
- Clinical Trials
- Neurology
Background:
- Headache is a common complication during hemodialysis, affecting up to 76% of patients.
- Caffeine withdrawal has been hypothesized as a cause of hemodialysis-induced headaches.
Purpose of the Study:
- To compare the incidence of headache and hypotension in hemodialysis patients consuming regular versus decaffeinated coffee.
Main Methods:
- A randomized, double-blind, placebo-controlled, multicenter study involving 156 hemodialysis patients.
- Patients received either regular or decaffeinated coffee during 12 dialysis sessions.
- The primary outcome measured was the incidence of headache during dialysis.
Main Results:
- Headache incidence was similar between groups (33.3% vs. 37.1%, P=.522).
- Hypotension rates were also comparable (27% vs. 26%, P=.539).
- Headache showed a trend towards being more frequent in the decaffeinated coffee group among non-hypertensive patients and those with high potassium dialysate.
Conclusions:
- Caffeine intake did not prevent headache occurrence in hemodialysis patients.
- Headache affected 35% of patients during chronic hemodialysis sessions.
Objectives:
Historically, headache was reported in up to 76% of hemodialysis patients. Some authors suggested that headache resulted from caffeine withdrawal. This study aims to compare the incidence of headache and hypotension between patients drinking regular or decaffeinated coffee during dialysis.
Methods:
One-hundred fifty-six patients were enrolled in this randomized, double-blind, placebo-controlled, multicenter study. Patients with atrial fibrillation were excluded. Group A was given 80 mL of regular coffee and group B 80 mL of decaffeinated coffee (placebo) in the middle of the session for 12 consecutive sessions. Ultrafiltration rate was fixed to a maximum of 13 mL/kg/hour. The primary outcome was the incidence of headache during dialysis.
Results:
A total of 139 patients completed the trial (6.4% vs. 15.4% of withdrawal in Groups A and B, respectively). The number of sessions with headache was not significantly different between Group A and B (33.3% vs. 37.1% respectively, P = .522), nor the number of sessions with hypotension (27% vs. 26% respectively, P = .539). In a subgroup analysis, headache tended to be more frequent in Group B (P = .06) in 2 categories of patients: those with the highest potassium dialysate (K = 2) and the non-hypertensive patients.
Conclusions:
Headache occurred in 35% of patients during their chronic hemodialysis sessions. Caffeine intake did not prevent headache occurrence in these patients.
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